the program came from both sides of the dais as well as the administration's own chief actuary during the 2009 debate over the affordable care act. was it ponzi scheme of the first-order. ofwe help you by getting rid the class act and that was one of those bipartisan efforts to improve the affordable care act after its passage in 2010. oxygen almonds time is expired. -- >> the gentleman's time is expired. >> with tongue in cheek support have got a couple of examples about the affordable care act.

my frustration is i served in the state legislature 20 years. i've been here since 1993. and i don't think i can think of whether serving in the texas legislature there was a law sessionhat the next didn't go back and revisit that law and fix it, no matter what party you were. that's what happened with the a formal care act. -- there were minor changes done in the last six years. but there are things we could have done in my committee, the ways and means committee, should have done, if it was so bad, you would have to wait to have a unified government like you do now. let me talk about the affordable care act and the benefits of does have. health care is deeply personal and sensitive. i think all are physicians will say that. to their patients, it's important. it is difficult to understand the stresses families are under

when faced with a loved one's needs and the inability to afford that care. i represented district where that happens every day for people who could not afford health care. of the life altering impact crushing medical debt. having to worry about being able to go to a doctor when you're sick or putting off health care because you don't have insurance or you cannot afford it is a grim reality that too many of our americans face. fewer do than ever before because of the affordable care act and that is why we are opposing her bill. because we think it'll make it work us -- make it worse. unfortunately, my colleagues will insist on taking us backwards. one of these metrics before us would produce worse outcomes. i can tell a story of a couple of my constituents who were --

who would be directly impacted by the circular for. i met ay, i worked -- young woman who worked as a page at the capital during high school and we had pages. she was diagnosed with arthritis as a teenager and was unable to obtain insurance when she aged off medicaid when she turned 18. it wasn't until the formal color -- affordable care act that she was able to get coverage that was affordable for her family and covered her condition so she could get the care she desperately needed. another one of my constituents wrote about her son who is diagnosed with [indiscernible] it's an inflammation of the membrane of the eye and is in the family of autoimmune disorders that include psoriasis and if i'm a tory bowel disease to name a few. -- and inflammatory bowel disease to name a few. condition got even more

complex when he eventually developed ibs. the diagnosis took months as the case did not display signs and systems consistent with any clear protocol. shared that his mother the story and the impact that the aca has on her family. he's in the fifth grade. he also attends math class in the middle school with his sister. on his own initiative, he tested at a fifth-grade math accelerate. he is a straight a student. he plays soccer after historically having two bad as a goalie for his team. he decided to get goalie training. he is now the top goalie from here to kingwood, which is north of our district. the kid has great and he has heart. on behalf of this young soccer star and millions of kids like him, be assured that i will fight the repeal of the affordable care act.

over the last six years, we could have worked together and fix some of the things before they got aggravated. as i heard from other colleagues, there is never a law that is passed or a bill that is considered perfect in congress or the state legislature. that's why i think him after six years of trying to repeal it, we should have done some real working together before that. i yield back the amount of my time. >> are there members on the republican side seeking recognition? who's next up on yours? we will go to the gentleman from pennsylvania. doyle: iative supported the amendment. there is a lot of amnesia on this committee. me remind my friends where we were before the affordable care act and what your constituents got for their money.

before the aca, insurance companies could discriminate against six people. we put a waiver on the pre-existing condition clause that they couldn't do that anymore that didn't exist before aca. in america, one of the leading causes of bankruptcy were people that were losing their homes because they had insurance but they had a child or someone in the family with a chronic condition and they come up against their cap and they couldn't get anymore payments and the insurance company they would hold fish fries to raise money to buy medicine for the kids and eventually went bankrupt and lost their homes. we put an end to that. we said insurance companies cannot cap your benefits annually or lifetime. that didn't exist before the affordable care act. women were being charged twice as much as men. we put an end to that.

children can stay on their parents policy until they are 26. that did not exist before the before book air act. we expanded the medicaid program. 14 million americans got covered on that. 11 a million -- 11 million which never had insurance before. for the first time, they bought insurance under the affordable care act. the did not exist before we limited that. so don't call this a failure because it's not a failure. failure, why is it you haven't just abolished all those things we did? no, you haven't. you are keeping pre-existing conditions. you are keeping caps on the benefits. you are letting kits stay on the policy until they are 26. because these are good things that we did on the affordable care act that the american people support. all you've done in this bill is basically give away $600 billion

over the next 10 years to corporations and rich people. you've taken that money out of the bill, and now the way you are going to pay for this is to eviscerate the medicare expansion program. medicaidcerate the expansion program and take the money out of the medicare trust fund. this is an improvement? you haven't done a thing to lower costs in this bill. you are going to see the elderly pay more for their insurance because these subsidies are not based on one's income anymore. they are based on their age. -- you'll be able to charge insurance companies five times as much as they understand the program where right now it is three. things that you are making such a big deal that you are keeping because, if you didn't keep them, you guys would be tarred and feathered out of

your districts. you keep them because these were things we did, that everyone of you voted against when we did this with the affordable care act. so don't stand here with those of us who did this bill and lose 50 of our colleagues their position because they knew it was the right thing to do and cast their vote anyway and try to take credit that you have somehow done something great for the american people. the only thing that's any good about what you are proposing are the things that we did eight years ago in the affordable care act. i yield back. recognizes the vice chair of the full committee, mr. barton. barton: i rise in opposition to my friend from new jersey's amendment. i don't think we need to debate on that. for comment on my friend from pennsylvania's comments, this is my 31st year on this committee. 31 years.

i will never match a john dingell, who was on the committee probably 50 years. i hope i don't either. i want to knowledge that i think you all set a record for the longest time period between the opening of a full committee markup and the actual calling up of an amendment. [laughter] i believe that would be a record. i don't know that is necessarily a good thing. but in terms of the minority doing what minorities do, i would have to say you did a good job. so i want to commend you on that. >> [indiscernible] representative barton: first of all, what we now call the affordable care act actually was

initiated or unveiled and debated, i was the ranking and i triedber mightily to engage mr. waxman, who was the chairman, in a bipartisan effort on health care, with the approval of the minority leader and the minority whip. and mr. waxman was amenable to do that, but he never quite got around to it, until the day that we were finally supposed to meet , he called me up and said he had to post power and -- postpone our meeting. i said why? we have the ability 11:00 and a press conference. so some of the things we were were into work on and what became the formal care act, we supported at the time. we supported coverage for pre-existing conditions. youngported keeping

adults on their parents' plans and things like that. so that's why we are keeping them now. we didn't oppose a part of the bill. but i do want to substantively comment on this "we are of us the medicaid expansion." i personally think we are too generous. i have an amendment, at the appropriate time, to tweak it a little bit. but having said that, the people that are in states that accepted the medicaid expansion funding, 100% federally funded, we are not kicking one of them off. they stay. as it is currently drafted even allows states to add additional medicaid untilion enrollees december 31, 2019. lets them be added.

and then, once we do put a freeze on adding additional medicaid enrollees, it allows or relies on attrition to take that population over time back down to the traditional medicaid match rate. that is not evisceration. is, if you are in a state that expanded medicaid, you are allowed and you get 95% federal funding. right now, it's 95%. finally, it comes down to 90% for perpetuity, which i think is another minor problem with the bill. but that is a fight i have to fight on the side of the aisle. that is not the akoni and -- that is not draconian. let's have a debate on the facts, mr. chairman. i would be happy to yield. >> if you have any faith or

confidence in your state in your state legislature, i would argue ofrly all of -- nearly all the stories we heard today are people who are on medicaid who can continue on medicaid. the argument is over whether the federal taxpayer, whether we have to borrow the money from some meals to give it to the states, many who have surpluses, by the way, at a different match rate. 90%, the match rate is 50% to 70%. the question is what a share the meadow -- the federal government should pay versus the state and local government should pay. that is the argument we are having here is. >> my time is expired. i oppose the pallone amendment. for what purpose does the gentlelady from illinois seek recognition? >> moved to strike the last

word. >> the little -- the gentlelady is recognized. >> i do support the amendment. to address what we have just been talking about, about the states and about trusting them and about the governor's. because what we know is 32 of , we can figure out is the majority of the states, did expand medicaid. and republican governors now are the lawcerned that would force millions of their low income earners off the insurance roles. here's what nevada governor, republican, brian sandoval had to say today. he said we've said all along work with the governors, that it should be a governor-led effort, and for the congress to rely on the governor's. he said they came out with their

own bill which doesn't include anything the governors have talked about. so the republican governors who represent the majority of the republican governors come from states who did expand medicaid. -- willthe gentleman the gentlelady yield? is that what the governor of arizona said? >> they came out with their own bill that doesn't include anything the governors have talked about and i'm that he is referring to the medicaid issue. this was a plan that, in my state of illinois, 3 million mark people will be able to get health care. and my republican governor made it very clear that this provision, that this part of the repeal and replace simply does not work for the state of

illinois and for poor people. let's trust of the states. let's trust of the governors. they are telling us this is a very bad bill for them. now i would like to share this story. i have a couple of women in my district who have benefited from the aca. my constituent brenda has lupus. before the aca, no insurance committee would cover her in the individual market. she works part-time, so she relies on the insurance her husband received through his job. her husband, unfortunately, lost job. because of the aca, brenda and her husband were able to get insurance through the marketplace and cannot be denied coverage or charged more for it. but under the republican rick hill, brenda and her husband could be charged massive penalties by their insurance company if they did not obtain

insurance after brenda's husband lost the job. so we talk about how great this is and how you are keeping protection for people with pre-existing conditions. who hasou have someone lost their covers because they lost their job for 63 days, for then,bout two months, yes, they can get coverage for at least a 30% increase in the premium. add insult to injury, the republican repeal will cost -- cause premiums to rise and will allow insurance companies to charge older americans more for their coverage. so brenda and her husband could be charged considerably more for their insurance. they were face, as i said, the 30% penalty imposed by their insurance company if they were unable to maintain continuous coverage

after brenda's husband lost his job. i got a bunch more of the examples we are all talking anecdotes. but ultimately, we are talking about millions and millions and millions of people who will either have to pay more and get less or lose their care altogether. let's go backgest to the affordable care act, which you have affirmed that many pieces of it you like, you want to keep them, and let's start with that as a base and figure out together how we can craft a plan, not a repeal and replace, which really isn't -- which this really isn't anyway, to come up with the improvements that any big bill like that would need. i would say to my colleague, mr. barton, you say you liked a lot

of the legislation, but you voted against the affordable care act. why can't we start now? we tried for six years, but we can start now, take the bill and try and make it more workable for everyone? and i yelled back. >> the gentlelady -- i yield back. hashe gentlelady's time expired. member butterfield is recognized to speak. >> let me rise in support of the loan amendment. mr. colognes amendment accurately describes what will happen if this legislation will happen. if you don't believe it, wait for the cbo score that will be week.hed next let me draw your attention to the incredible impact that the affordable care act has had on individuals in the life-saving benefits it has created for people in my district in eastern carolina.

since the aca was signed into law, millions of americans have gained access to quality health care services and hundreds of thousands more have seen their health insurance improve. the aca has played a significant role in reducing worry among americans who previously struggled to pay unaffordable medical bills when they got sick. we cannot afford to go back to the days when americans were forced to pay more money for less coverage. and when insurance companies ration the care, people receive -- ration the care people receive. my constituents do not want to go when a health-care emergency could bankrupt them. rip health care away from my constituents and come i believe it or not, from your constituents. the aca saves lives. today, i want to show the story of julie chamberlain, who lives and works in my district in greenville, not her line of --

north carolina. old. is 55 years for the first time in her. life, she is able to afford health insurance because of the aca, even though she has a pre-existing condition. -- the aca,s ca julie tried to get coverage but could not afford the expensive policies she was offered due to her pre-existing condition. repealing the aca will endanger health care for millions of americans. them.is just one of because she is over 50 years of age, julie is at risk of no longer being able to afford health insurance under the replacement plan because this bill will allow insurance companies to charge much higher premiums for older americans than they were allowed to charge under the a formal care act. 10 fact, the bill is estimated to raise premiums for older $3200.ns by

that is a lot of money for people trying to put food on the table and trying to pay for their children's education and to keep up with their bills. people sadly cannot afford that amount of money and would lose coverage altogether. and the thought of losing her i know, ifjulie said " the aca is repealed, i will not have health insurance any longer, and i worried tremendously about losing my coverage." please listen to julian the millions of americans like her who are living in a state of worry that this bill will make their health care unaffordable. julie's story is one of more than 35,000 people in my district alone who now have insurance as a result of the aca. i heard from many of them on saturday, february 25, when i had a town hall meeting in durham. like many of my democratic colleagues, i heard from more than 600 constituents who support the aca. even though my republican

intoagues fear public action -- public interaction and are missing in action, my constituents deserve to be heard. like julie, many of these individuals would no longer be able to afford health care insurance if this is repealed. this bill is also alarming because it will prevent states, like north carolina, and i do not trust my state legislature, like north carolina the did not expand medicaid, from choosing to expand in the future. this bill stands to black more than 650,000 north carolina is from gaining coverage under caroliniansnorth from gaining coverage under medicaid. it is unacceptable. i will do with -- i will do anything within my power to nians andorth caroli

americans to have coverage under the aca. i yield back. the chair recognizes the gentleman from kentucky. >> thank you, mr. chairman. welier, you talked about -- did vote different bills and although those people were saying are just a repeal. there are bills that we all voted for that were to improve and try to help people that were being affected by obamacare. by2015, a bill authored --gressman hardiness and i there was a voice vote in the senate. this is what the build it. obamacare was set to change the definition of a small group employees, one to 50 one to 100 employees. that means employees across the

country were about to be forced in the plans loaded with mandates and regulations like essential health benefits and chp's, by giving stasis option, democrats and republicans recognized that this is important. we gave states choice and protected them. single member on either side of the aisle stopped the process and it cleared both houses of congress by a voice vote and signed by the president. so the question is why should individuals be treated any differently? why would members on the other side of the isle discriminate of -- discriminate against those out of work? why would we not have the same would raisethat prices for the health insurance that we gave the people in the small business market? we also learned that states respond well given choice. there is a map that's been posted of 46 states, when we gave them the option to not

change the definition of a small group market from one to 50, 1 to 100, responded to that. we should give patients really from mandates and give states choice to allow that for individuals like we did for people in the small business market. >> for the gentleman yield? it's important along this context, during that 2010 year, led by mr. dachshund others, there was a request of the then majority to do oversight of obamacare. some 13 different requests that we quickly documented. of course, they were denied. i want to share a story, too. there are stories out there where obamacare has been a net negative. mrs. dana or klamath county, she wrote to me just a few days ago and said "please repeal obamacare to give us some relief . our health insurance for two, the standard silver is $1850 a

month. we cannot afford that, so change the standard bronze, half the coverage and still cost more than the standard silver did last year. it is $1501 a month. on top of that, we paid $11,000 in medical bills. this is totally outrageous. we are cattle ranchers. our product has lost 30% of its value in it -- in the last two years. government is forcing us out of business. please continue to support repeal of obamacare. from shootsay county, a small business owner said i received a letter today from my insurance company, providence. they will not be offering my plan next year. to get a plan similar to what i have currently, $939 a month, my new premiums will be $1503 a month. by the way, this plan is for a

family of three who is self insured we own our own small business. 65 hours a month in order to pay for health care for my family or i drastically raise my prices to cover the costs, which makes it more difficult on my customers. does anybody understand this major domino effect that is happening? in the last three years, my premiums have gone from $685 a ,onth up to $1500 a month $18,000 a year. so this law is actually hurting people in my district. we have expanded medicaid in my district. we kicked no one off who is on it today. so they are there. at the higher reimbursement rate. we are trying to strike this balance where we repair this individual market that inescapably, factually is collapsing. it is collapsing.

countieshere was 225 that only had one choice. this year, it is 1022. there's five states where there is one choice. that is before humana came out of the market and before the aetna ceo said it is in night death spiral. we are trying to get to where people like dana and april can't afford health care insurance. matsui: i move to strike the last word and i support the pallone amendment. elizabeth is a mother of a young daughter with type 1 diabetes. to me, "no parent wants their child to get sick, especially not get a chronic life-threatening disease but that is a life we are now living." she wrote to me about her daughter's future and her concerns for her entire family. as she so eloquently said, "my

family plus very existence is dependent on my child's access to health care. husband ared her teachers. , if we "done the math had to pay out-of-pocket for our daughter's health care, it would cost more than an entire year's salary for a teacher." choice is to keep her alive and this is going to be a costly concern for the rest of her life." tozabeth asked me to fight keep health care for the most vulnerable. that is why i'm sharing her story today. we should be working together. all of us know that -- no and elizabeth in our lives. we should be working together to improve the affordable care act and build on profits we have made, not rushing to tear it down. we should be trying to make access to health care easier for

elizabeth and her daughter and the millions of parents and children like them. instead, this republican bill would rip health care away from millions of americans. for all but the healthiest and wealthiest in a nation -- our nation. we are offering them less coverage, fewer protections, and higher costs. areepublican colleagues telling the republican -- the american people to cross their fingers and hope they never get sick. but as elizabeth and so many families in every community in our country no, sometimes that is not how it goes. mr. chairman, these families deserve better than being asked to pay more for less care. thank you and i yield their major of my time to mr. leon -- luhan. lujan: there are a few

articles and want to reference. there was a political article titledebruary 20 of 2017 "how mike pence used obamacare to halt indiana's hiv outbreak." the worst health crisis to hit indiana indicates he turned to obamacare. the program he vilified and voted against. my 15 as a rash of hiv infections rose scores ofy enrolled people into the expanded program. they could get medical care and substance abuse treatment. many were addicted to opioids and had contracted hiv by sharing dirty needles. on march 7, oregon governor kate brown said tuesday that ealth cares' h

replacing proposal moves health care backward and the statement that the democratic governor said since the affordable care act also known as obamacare took effect, oregon's uninsured rate trapped from 17% to 5%. of oregonians now insured. she predicted the republican 'lan would reduce oregonians access to health care and increase costs for women and seniors. other courts they think are important to note for my colleagues. club for growth opposes ryancare.americans for prosperity , take it back to the drawing board they said on march 5, 2017. americans for prosperity, freedom partners oppose the house bill. heritage action, republicans should begin a genuine effort to deliver on long-standing campaign promises that create a

free market health care system and empowers patients and doctors. freedom works. it allows insurance companies to assess a 30% penalty on those who do not keep continuous coverage for 63 days. a differentit for reason but they go on to say which is an individual mandate by any other name. many other quotes, mr. chairman, then i plan to share with our colleagues. with that, i yield back. mr. chairman: chair recognizes the gentleman from ohio. >> thank you. i would like to rise in opposition. i know we have been talking about a lot of our constituents but i would like to contribute what i have heard from my constituents from. perryburg. i do not have insurance. i do not ask the government for

any assistance. the thing i am upset about is that i will be penalized for not having insurance holy around $1000 -- probably around $1000 this year. the money would be better spent -- saved by me in case i need to go to the doctor. my husband left me after 38 years. my insurance left also. i work hard and save my money. i was also working 30 hours per week before and now i am allowed to work 24. i was heard by obamacare. why does the government need my money? "i am on the exchange and there is only one provider available. however they do not offer any service in delphus. to sign up i have to give up my family doctor, my wife's ophthalmologist, might -- might

orthopedist, and my hospital of choice. -- they received their insurance quote of a 44% increase. instead of giving their employees raises or buying more machinery they can hire more people, they were paying more for insurance. --ther small company of rip 15 received theirs, 65%. another constituent told me he has insurance. he cannot afford to use it because of the high premiums and the high deductibles. constituent, i would like to see some change in the health care law with regard to insurance premiums. we are a family of four. my husband has had numerous surgeries in the past 15 years. before obamacare, we could afford insurance and not have a

high deductible and pay for the life-saving medical services that were provided. since obamacare, our names have gone up every year along with very high deductible. amount about the same that we pay for our mortgage. $5,000.ctible is we are in debt $17,000 and just medical bills. we can barely make payments and all the bills plus our premium each month. something has to be done. we did not struggle with this before obamacare. please help. i do not believe obamacare is the answer because of the rising cost of the refusal of some doctors to take on some insurance companies. my husband is 63. i am 62. together, we have a check for $2300 each month going to health insurance. has axpensive policy

$3000 deductible each or $6,000 for both of us. expensivee both on medications, we end up paying an additional $6,000. my husband is self-employed. we are responsible for paying our own. because of the rising cost of health insurance, we are making our employees pay a higher cost each year. however, we have been losing money so we had to close the business and for men lost their jobs. as for my husband and myself, there is light at the end of the tunnel, we finally hit 65.5. we have little funds put away for our as we are closer to that time. our son and his wife who are on thatare last year found they were limited to doctors and hospitals they could use. they could not keep their current doctors.

i know you have a huge task ahead trying to come up with a new plan. i wanted to give input and what was happening to us in northwest ohio and in middle america. yield back the balance of my time. are there other members wishing to speak or could we go to a vote? i am sorry. the gentle lady from california. >> i asked for unanimous consent to place two documents in the record. one from dr. mueller in my district, the other a u.s. news & world report piece by david entwistle who is the ceo [indiscernible] the gentlelady from california will be

recognized for five minutes. >> thank you for recognizing me. pallone's a mr. minute renaming the bill a more for less is apt. it is a much better description of what will happen if this is enacted into law. you do not have to take it from me. the opposition has been pouring in all day and i thought it would reference a few of them. the american medical association has come out in opposition to the bill. they say in part, more than 20 million americans currently have health care coverage due to the affordable care act and among the ama's highest priorities for ongoing health system reform efforts is to ensure that these individuals maintain that coverage. while we agreed there are problems with the ac that must be addressed, we cannot support the gop bill as drafted because of the expected decline in health insurance coverage and

the potential harm it would cause too vulnerable patient populations. they sign off, we urge you to do all that is possible to ensure that those who are currently covered to not become uninsured. easter seals has also weighed in in opposition. they areeaster seals, a leading nonprofit organization that helps individuals with disabilities access their and especially under medicaid. easter seals is greatly concerned that the gop bill removes the federal funding guarantee that currently exist in medicaid. people with disabilities rely on medicaid for services such as attendant care, adult day and home health services to remain in their homes and communities. restricting medicaid resources by capping the federal amount available to states and including further reductions based on aggregate medicaid expenditures will further limit access to services. alsoational nurses united

opposes the gop bill. on behalf of the 150,000 registered nurse members of national nurses united, we urge you to oppose the gop bill. the american health care act poses a mortal threat to the health and well-being of our patients and to the health security of our country. in fact, there is not a single aspect of this legislation that will benefit our patients who lack the health care services they need. the leukemia and lymphoma society also say that on behalf of their society and the one million -- 1,200,000 americans living with a blood cancer diagnosis, their writing to urge leaders and members of the energy and commerce and ways and means committee to vote no on the gop bill. health,t for america's they are a nonprofit, nonpartisan organization. they say under the proposed bill, millions could lose health

insurance and we are particularly concerned about access to health coverage for those with limited income. without affordable insurance coverage we will see increased levels of preventable illness, injuries, and death. in addition, we believe it is important to guarantee that all insurance public and private offers evidence-based preventive services without cost to patients. there are many more and they will keep pouring in, i am afraid because what they want us to do is what the democrats have been offering to do, let's slow this down, let's begin to work together. i have listened very closely to my colleagues' stories from their districts. remember, it is not collapsing everywhere. in florida, we have 1.7 million floridians who went into health the health care website and found affordable insurance. why don't we sit down and work together on how we brought in competition in areas of the country that do not have it?

inknow that there is nothing the bill to toggle the high cost of pharmaceuticals, that is an area that i was hoping we could sit down to, but turning this into a more inefficient, costly system, where people do not have insurance and then the folks with insurance have to pick up the tab because there are -- there other neighbors will have access but they will not have coverage that provides financial stability in their lives, that is not the way to solve this problem. it is costly, it is an efficient. i think we can, we own the iraq and people much more. i yield back. chair: the chair recognizes the gentleman from oklahoma, mr. mullen for five minutes to speak on the amendment. mullen: thank you. i rise to oppose the amendment. there has been a lot of talk about this not being affordable from theing it away american people. i know my colleague from florida who just was speaking, it is

working and florida. it is not working in other places. in oklahoma alone through the 76% increase.w an arizona, last year alone, we had 116% increase. are the premiums skyrocketing? because of the mandates from obamacare. it is not affordable. in -- our colleagues on the other side know this, so why are they arguing? why are they having this conversation? we are talking about being honest with the american people, they know it was [inaudible] regardless of who got elected. if it was hillary clinton or current president trump. where going to have a discussion about -- we are going to have a discussion about health care with the american people. why is it that this is such a surprise to the other side? me and my colleagues, they came

to us and said we are going to have to work together on this, are you willing to help us? our question to them was, why? it is yours. it is your baby, you fix it. i was surprised by the answer that i received. if we do not, we're going to go to single-payer system. really? if we are going to be honest with the american people, let's be america -- honest with our intentions. what are the options here? we know we cannot keep up the weight is going. it is not sustainable. insurers are pulling out of the markets, there are fewer choices for the american people. they get our colleagues on the other side continue to want to argue for a failed policy. even to the point of saying it costs our colleagues 50 seats but we stood with it. the american people spoke up and said it is failing, that is why you lost 50 seats, that is why, it was a failed policy.

yet we are still here and we have been in markups since 10:30 a.m., and we have not had one single vote. because of a delay tactic? maybe it is because you guys have nothing better to do? trying to be insulting, but if we are going to get started on fixing something that you know is broke, at what point do we start having an open conversation? i have many friends on the other side of the aisle. i am open and willing to talk to people when we can have a reasonable conversation. but you cannot honestly look at the camera and say that this bill is perfect, that it was not failing. you cannot honestly say that there is more access that is more affordable today than it was in 2010. that conversation cannot happen. so what is the option? do nothing and let it fail? b was for youn

guys to single-payer system? or put it back in control of the american people? i think the american people made it very clear. they want control of their health care, not a bunch of bureaucrats in washington, d.c. but -- with that, i yield back. yieldsthe gentleman back the balance of his time. the derailment from vermont is next. -- gentleman from vermont is next. we are trying to stay in senior dirty. i do not want you to to get cranky with each other. -- we are trying to stay in seniority. we will go with the gentleman from california since he is so much more senior than the gentleman from vermont. i strike the last word. i am in support of congressman e's amendment.lon

i do so in honor of a constituent, denise jefferson. denise jefferson credits the aca with saving her life. she was diagnosed with: cancer age 41. cancer at but it wasolicy expensive due to her previous condition. a few weeks after being diagnosed with ovarian cancer, denise received a letter from her insurance company. it in front her that he were canceling -- and form to her that they were cance canceling their policy. it would not cover their covered -- leave five months of therapy to treat her cancer. buckley, the affordable care act had become law because -- she was able to cover her treatment and scans. been forys had it not the aca she would not be alive today.

fortunately, denise's story is not unique. she is among aliens of people who have received important health care because of the affordable care act. they would not have access before the affordable care act is -- was an active. we are looking at the republican care bill. it would analyze people who do not have continuous coverage. and punish those with pre-existing conditions. the provisions of the aca saved lives. it has expanded health care to more people than ever before. uninsured rates are at record lows. accesswere able to get to primary care physicians and this catches life-threatening conditions like cancer early enough to be effective for treatments. can we have order? chair: the gentleman may proceed. >> people no longer have to worry about coverage to have had cancer in the past. because of aca, insurance companies cannot deny coverage

for pre-existing conditions. we made great progress in regards to health care coverage in -- and health care access. that is why i support e's amendment.llon i would like to talk about my friend, the gentleman from illinois'smarks -- remarks earlier today. health care is tough, it is going to be expensive. it is clear enough that the democratic party believes the affordable care act has been successful but needs improvement. it is clear that the republicans believe that the aca is in a death spiral as we often hear. would improve things. the democrats do not agree with that idea and here is why. the republican bill in lemonade keep premiumsd to and to dr. bowles down. i do not see how that will do anything but cause premiums and deductibles to increase.

the gentleman is right. the democratics paid a big price for enacting the affordable care act and the republicans are setting themselves up to pay a big price. and the house of representatives, the majority if it has a will which is in doubt at this case, but i caution you, be careful what you wish for. you saw on the other side, you saw the turmoil we faced in 2009 and 2010 with our town halls and we got hammered in the election. you are getting hammered in town halls and i caution you, if you live in a competitive district, you will face a tough election. i yield back. >> will you yield? >> yes. >> it would like to say from our friend from obama, number -- none of this think this bill is perfect. i have never heard a single democrat say this bill was perfect. we knew that it needed work. we wanted for the last seven

years to work with republicans to try and improve this bill. you guys were not very interested in that. sure what the gentleman is talking about when he talks about mandates. what mandates in the obamacare bill does he take issue with? certainly not with pre-existing conditions or caps on benefits or letting your child stand policy to 26. i am curious, what is it we are mandating? men having to purchase prenatal care? is that not correct? >> reclaiming my time. >> should they? as alle is no such thing a cartrd insurance -- al insurance. >> you tell me what

insurance, and he will do that. there is no company in the world -- he is talking about something that does not exist. chair: the gentleman's time is expired. the gentleman from michigan. if we could have order. mr. wahlberg is recognized for five minutes to speak on the amendment. that alberg: i think chairman. as a freshman on this committee, i hesitated to speak up. as i listened to this amendment, initially a thought it would be like in most other committees it would be put up for a few comments and then withdrawn. it does not seem serious. it does not seem serious at all. bottom line is, what has happened as a result of the isordable care act is what

unaffordable. it has hurt people. i was here in 2008. was sent home for two years of r&r. the democrat who defeated me voted for this thing. i came back in 2010. since that time, i have continued to come back and the affordable care act has continued to be a problem in my district. let's get serious about this. is a pain -- pay more for less at, we are talking about the affordable care act. is a disaster. insurance markets are collapsing. health-care care costs are soaring, patients are twinkling --dwindling. tolive in a country we ought expound on that.

courseted and set the for the rest of the world and competition. i come from the great lakes state, i come from the motor did notof the world, we compete and found out we needed to compete and we came back. products, quality, everything. about for theht consumer. premiums increased by an average of 25% for the millions of americans trapped in a failed obamacare exchange plan. obamacare is unsustainable. it is hurting for more than it is helping. pay more for less, absolutely. that is why we are doing this exercise. that is why we are rescuing the people. needstrict in michigan rescuing from obamacare. let me just read some actual experiences like the rest of you, we can have a book year -- here.

marty from jackson, michigan. is retired and her husband is self-employed. in 2015 the purchased a bronze policy. with a premium of $250 a month and a deductible of $6,000 per person. in 2016, their premiums nearly quadrupled to 980 -- $989 a month. in november of 2016, they canceled their health insurance because why, they could not increase. premium now they are both uninsured. that is the affordable care act and we are dement -- debating an amendment that's his we're putting up something that will cost people more? you got to be kidding. gary from grand ledge, he was promised he could keep his health-care plan but when obamacare went into effect, his plan was canceled. gary's health insurance monthly

premium has gone from $450 a month prior to the affordable care act 20 $1100 a month. he cannot afford to pay $13,000 a year for health insurance. for the first time in his adult life, he and his family will be completely uninsured. mary from reading, her health care costs have gone from about four dollars month -- $400 a month to $1700 a month under obamacare with a huge out of pocket payment. she has gone with a plan she did not want to get cancer treatment across the state lines in indiana. her costs have gone of fixed eventually. she says she will go bankrupt this year because of it. i could go on and on with that. again, i thought that this would be an amendment republicans pay more for less care act would be something just to postulate on. i guess it is legitimate.

is a farce. that is why we are fighting this tonight. fact, the affordable care act was unaffordable and you have paid more for less and you did not have a choice. let's give the people a choice. i yield back. --ir: the gentleman year yields back. recognizing the derailment from vermont, mr. welsh for five minutes to speak on this amendment. is an important amendment to allow all of us to tell [inaudible] -- stories about the individuals we represent. listening,een here some of the stories are powerful resultut people who as a of the failure of the individual market suddenly find themselves without insurance, high and dry.

some of the stories are about people who thought they would never have insurance within reach and they have it as a result of the affordable care act. time, they have got cancer, they have kids with serious conditions. we tell our stories but then we do not analyze what the problem is. insurance about the that you want and it reminds me, i have a neighbor, shorty sawyer, some of you know in your district, incredibly hard-working, not educated very well, he's to do maple syrup, he used to cut cordwood for sale. plow driveways. worked in the woods a lot. and he managed through dangerous injury for 60hout years. and one day in the woods, he

dropped a tree on his shoulder and he was -- it was badly fractured. andmy neighbor was around drove him to the hospital. shorty was very proud because he thought he had insurance. it was a company called golden rule. he had been paying for years. he did not have much money. he thought he was doing the responsible thing. he got to the hospital and found out that his policy did not cover any kind of hospitalization. he had been paying money forever . thought he had coverage, he had a legitimate, incredibly -- incredible injury out there in the woods and managed to get himself to the car and found a neighbor and took him down. the coverage he had was nonexistent. that is the problem about the rhetoric about selling stuff across state lines. that is fine. under this bill, you can do it, you can sell insurance across state lines, but it has to meet some standards.

>> that is not in the bill. just so you know. >> in the affordable care act. my point here is that the stories we are telling that move each of us as we tell them because it israel people with real lives -- it is real people with real lives with insurance, they are true, they are both true. if we are going to be responsible to solve the columns you're talking about with people you represent, and i have some people in vermont who are by and large in support of the affordable care act. me tostories were telling appeal -- repeal it because they cannot afford it. i write back and say you have a problem and we have a responsibility to fix it. repealing the health care bill will not solve your problem. my view is it will make it worse read we could have a discussion and debate about that. but these stories are quite

important because they are really true. they are both true. if we disregard the reality of the experience of your people and you disregard the realities of the experience of the people whose stories we are telling, we end up in the same place. and theixed up system hard-working people of this country being insecure about whether they have health care. the folks who have plenty of money do not need us to pass any bill at all. the vast majority of americans, most of those folks, they have 20 or 30 or $40,000 in for retirement. they are a paycheck away from losing home. -- losing a home. they just think how it will be possible to put their kids through school and health care has been outrageous. it marches up in its costs. no control over the cost. we are doing nothing about addressing the structural costs

in health care. for service system is broken. you do not know how much it will cost, tell me, time is spent, how much material you spent and we will pay the bill. that is a disaster. quit -- quote a certain american. the stories are, in a way they are compelling because they are real. story youy of the tell does not deny the reality of the story we tell. there ishat suggest some mutual obligation here? helpse a final story that the folks you're talking about? it deserves the -- who deserve the protections of the people we are talking about. i yield back. chair: i appreciate the gentleman's comments. weare constricted in what can do but it is my intent as chairman of the committee to

pursue the cost drivers of health care and hopefully in a bipartisan way. as i say, we cannot do much of that here, necessarily. believe me, i have had people talk about the program, about a lot of things. and i concur. hopefully when you pass this piece, we can come together and we can look at these in a very thoughtful way. i heard the other day about a naloxone injector, the same deal as epipen. and nine fold increase, they told me 5600 bucks. is outrageous. we are going to look at these things, i assure the gentleman. i appraise -- appreciate his tone, tenor, and commitment to work with us. i think mr. johnson was next. on our side of the aisle. mr. johnson: thank you. from ourard the cries

colleagues on the other side of the aisle talking about, slow this process down. as are several of my colleagues on this committee at which thee pace affordable care act was put in place in 2010. mr. chairman, i think you have gone way beyond the point of reasonableness and allowing transparency and debate on this record a call issue because this kind of transparency and debate did not occur when the affordable care act was put in place in 2010. i have heard talk about real people with real lives and real problems. let's look at some of those people in appalachia.

proctor bill, ohio. there is a story. we just received notice from our health care provider that they our individualng health care plan because it does not meet all the requirements of the new health care reform laws known as the affordable care act. result, on our new renewal date, they are transitioning us to a health care plan that is compliant with obamacare. our monthly premium will go from $5,100.$403.91 to increase.400% how can they call it an affordable health act when it will cost up to four times as much? here is one in my hometown of marietta, ohio. in generate my health insurance premium with lacrosse blue shield was $876 month.

up 9-23 it went t and got canceled altogether. i was planning to hire a marketing coordinator for my office in december but not now. not until i can figure out what my costs will end up being. bel air, ohio. i am self-employed. my wife and i have been on the ohio valley health plan for about 20 years. bones, $722 or month. $8,200 coverage with co-pays. it has changed to $980 a month, 60-40 coverage, $4500 deductible each, that is $9,000 in deductible and higher co-pays. when asked why such a drastic change occurred with seemingly less coverage, i was told, because they had to. my wife and i are 58 years old. we are in good health.

we are getting to the age of maybe needing health care, now we are worried it will not be there for us. affordability, here is another one. for the first time in several years, my husband and i will not be covered by health insurance. my plan does not meet the obama standards and is being canceled. we do not qualify for any credits or subsidies. we cannot afford the expensive premiums being offered. cutting backring on some of our customers in order to reduce our income so we can qualify for assistance. not only will we not have insurance but we will also be fined. this is ridiculous. here's is one in carrollton, ohio. marrieda 58-year-old couple. neither my wife nor i are smokers. under the affordable care act, 2009, a $544 a month premium.

increased toad 1340 six dollars. look at that increase. here is the big one. $20,000 per year for health insurance with a $9,000 deductible. since obamacare has started. mr. chairman, there is a big difference between coverage and access. when you have got a $20,000 a year from him and a $9,000 deductible, that is $29,000 out of your pocket before the insurance pays a dime. that is not access to affordable health care. people are not going to use their insurance when it comes -- costs that much. i rise in opposition to my good lone's amendment because it is simply not true.

i yield back. chair: the chair recognizes the gentlelady from colorado. >> thank you. i am glad you are in the chair because i want to talk about this statement that you made earlier to mr. doyle about having to get coverage for pregnancy. the truth is almost all employer-based plans cover a whole range of benefits for people. what we are really talking about is the individual market. most people on your side of the aisle are talking about these horror stories under the aca in the individual market. as we established earlier this evening, earlier this evening, we established the essential benefits from the aca still stay in your bill. so what we need to do rather than have a big general debate

about the aca, we need to look at this legislation that is pending before this committee , how, and we need to say is this pending legislation going to impact what is happening in the aca? aca, only 12%the of the individual markets covered maternity health care. so what that meant is, if you ise a woman and this international women's day so maybe that is not the best thing for you to be saying, mr. chairman. this is only 12%. nature had to pay more for insurance because they were when -- women. they could get pregnant or need birth control or have issues. that was eliminated in the aca, helping millions of women be able to afford their maternity and childcare and childbirth. now, you know, you have to look

and see, does this bill address the problems that you're trying to identify, and what we are trying to say on the side of the aisle is that in fact, there are issues with the affordable care we know we now -- need to fix them in a bipartisan way. we know that. what this bill does is it makes it even worse for the people who have been able to get health care. i want to talk quickly about two month, i had a listening session in denver for people to come and talk about how the affordable care act impacted them. i had 200 people show up at this listening session. they could not all talk but i got a lot of them to write out parts. a couple of them talked. one of them was amanda miller. here is amanda miller, she is a young woman, she and her -- i think they are in their 20's --

she and her husband, they changed jobs. while they were unemployed, they decided they should buy an insurance policy on the exchange because they're good citizens and they thought even though they were healthy, what might happen? right after that, they got in a terrible car accident when they were visiting her parents at christmas. . truck fell over on them as she said to me, she said, you could see more of my husband's see of hisyou could scalp. she said if there was not a car full of nurses following them, he would have bled out. can you imagine, she stood there and said that in front of 200 people. she said that he has now had to said19 operations and she her hospital bill was $16,000 was paid in full because they were on the exchange. now she is worried because if

you take that away from them, number one, they would not be able to pay for that hospitalization. number two, he would have a pre-existing condition, and his insurance rates would go through the roof. fact, his health insurance company molina said if the republican bill today passes, premiums for people like amanda and of every else are going to jump more than 30% in 2018. that is on top of the current premium increases that are projected under the aca. how are people like that going to pay for insurance? just quickly, one other story and want to tell you. lisa of denver. she got an immune disease and she was only able to get -- work part-time. she is not eligible for insurance to her employer. the high risk pool had a long waiting list and she could not

afford the premiums. she got more diseases, she finally got a part-time job, but could not afford the insurance. finally, she went on the medicaid extension and now, she can afford treatment and she does not have medical debt. what is going to happen to her? , addressing a serious illness required to arduous battles. recovery and then repayment. before the aca, the number one cause of her -- of personal bankruptcy was medical bills. we can sit here all night long and i suspect we may. allyou guys can talk about the people who were harmed by the aca and we can talk about the people who benefited. but in truth, we have to see if this bill solves the problem. i humbly submit that it does not . we should scrap it, sit down, try to fix the problem together. chair: the gentlelady's time is

expired. the chair recognizes the gentleman from pennsylvania. mr. costello: i want to echo the sentiments my colleague from vermont said, both sides have stories and they're both true and that is very much worth stating. it is a point of frustration that it is now 9:20 p.m. and we are certainly willing to be here for as many days as it takes and we are on the first amendment. when the hearing started at 10:30 a.m. and it is about the name of the bill rather than substantive amendments, and i believe it would be very helpful in the spirit of working thether to have an advance amendments are going to be offered, i believe as them ranking member indicated, there is going to be hundreds of them. because the stories are true and we can't -- because we to improve our health care system, the earlier we have the substantive amendments and we move on to defending -- debating the substances -- substantive

reading the text of the bill for an hour, all of rather than time dealing with our health care law, i imagine every single person watching as is waiting for us to talk about the delay or and not protract that discussion. talking about with the name of the bill is going to be. or disrupting these hearings by having to go to the floor for martians -- four motions to return -- adjourn. ther: chair recognizes derailment from new mexico. >> i want to thank the staffer for taking the time to read the bill at my request. got ane on this committee thorough reading of the bill. and the complexities associated that are built into this bill with the sections that are referenced that were not read,

hope the members of this chamber take the time to go and see where those references are and read those parts of the bill that they know that -- what they are repealing. this is an important process. making sure that we have time to look at this language is critically important. rather than ramming it down the throats of the american people. no hearings on this bill, this is the first day of hearings. the first one on this bill. that was posted at 6:00 p.m. on monday night, i was told. so thank you to general counsel. i know it was not easy. i tried to keep up with you my you're trying to get through pretty quickly and i respect that but at least he gave an opportunity to do that. in response to my colleague esther johnson about the openness with his -- this process, here is what one of our colleague said -- colleagues said, i do not know if you could call him a moderate. a very conservative self identified leader in the u.s.

senate to it -- in the u.s. senate. mike lee said this is the exactly the time of backroom dealing and rushed process that we criticized him regret for and it is not what we promised the american people. we do not know how people use this tax credit, we do not know how much of a cost, and we do not know if this bill will make health care more affordable for americans. one of our former colleagues -- >> will be german yield? >> yes. >> one of your colleagues voted for the bill and i took his place in 2010. i yield back. that.ppreciate when mike lee says this is the kind of backroom dealing that rush the process through that democrats are criticized for, i do not the you disagreed with maker you just said you beat him. so kudos to you. it does not change that this is a backroom deal that did not make the light of day. >> will the general men yield?

-- gentleman yield? >> no, i won't. cbo cassidy called for a score and wants to see him a people lose coverage, how much is added to the debt. chairman, i know chairman walden's not here. i do not know if mr. burgess will be able to answer this question or committee staff, mr. burgess being the chairman of the subcommittee. chairman walden in response -- in response to the observation that people could purchase insurance across state lines, chairman walden said this is not in the version of the bill. at a press conference earlier today with speaker ryan, speaker ryan said it will be in phase three of the bill. can anyone of my republican colleagues in lightness on that? about thistalked being in three buckets. the first bucket is reconciliation which is the process going on today here in energy and commerce and ways and

means. the second bucket is what secretary price can do through his power and it is a lot through hhs. the third bucket is going to have to move legislation that crosses the 60 vote threshold in the senate, that being one of them. >> i appreciate that explanation, mr. chairman. aain, will this committee get score of how much this is going to cost the american people base that this is built in three phases? i do not know that anyone of our colleagues can answer those questions which is why several more of our colleagues have gone just one second. i have a question for you as well. michael cannon, this bill is a train wreck waiting to happen. national review, it is a disappointment, not too late to get a second opinion. i would be happy to yield to you. one thing i want to understand -- you were are asked a question about the

numbers going up. that -- you said that was a good thing because it restores personal liberty. cbo score, that was requested in early january and we are still awaiting that result. we will not have a cbo score -- mr. burgess, you said you requested the score on this bill in january but we were told as late as thursday that there was no bill that was ready for the public to see. what is going on? i yield back. there have been drafts of this build a happy and worked on going back into last year. the fact that we have been -- the information made available to republicans are made available to minorities. the chair recognizes the

gentleman from michigan. the gentleman is recognized for five minutes. remarks fromte the the gentleman from for mont because those personal stories to drive us. we do know those people. on both sides, winners and losers. for those of us on this side, we have probably heard from more folks that think that obamacare has been a loser for them. i can remember going through a company in my district, and they were scared to death because of obamacare. the employer was going to drop their coverage and they would simply pay a fine and they would be put into the exchanges and they would lose a much better contrary toectly you can keep your plan if you like it. i remember a few years ago i had a bill on the house for that a good number of democrats voted for that you could keep your plan if you liked it. which was one of the underlying promises of the bill that passed

the house and did not get through the senate. as i look at the good work that this committee did on 21st century cures, it is those personal stories that drove everyone of us to support that bill. we passed it unanimously. joe barton and i are among those who were here in the 1990's. we can remember a bill offered packagetisan packers -- that was bipartisan on health care. it was not run up because it would have defeated the hillary and the committee did not want to take that embarrassing vote and it was probably one of the reasons why the house flipped in the 1994 election because of that health care debate as i remember. as we all think about, i was one as many of us here on the side believe that we did need health care reform. we can remove those stories of

prescription drugs going to senior centers and watching seniors literally cutting their sols in half at meal time that those pills will go twice as far and that is what we great credit to president bush 43 because that was a driving force for him, a wonderful accomplishment that he campaigned on and delivered and seniors are much better off i think generally by about 85% approval rating of that new benefit that the congress did. if we look at this bill, i have to consummate the many ideas that we have been working on for some time. we have talked about the kids under 26 years old, we had a good number of students from michigan state who were in the audience, they like to that provision that we have. it is bipartisan. ncsa -- hsa'sike quite a bit. that will come through the ways and means committee so we can do that.

most of us, all of us i hope want to make sure that pre-existing and it -- conditions are not discriminated against as people look for health insurance. cap on insurances. people were concerned they would hit that target and no longer be eligible for health insurance. that.k care of a number of us worked with our governors on both sides of the aisle to make sure there was a safety net in essence for the states that expanded medicaid and that will last for all of entrants through 2019 until they naturally move on with attrition, whether they become eligible for medicare, get a job, whatever it might be. what i am saying is, these ideas that i think we have retained make a good landing place for all of us in a bipartisan way to say, yes, there are health care reforms that we want.

these are some good ones. and it has not happened here much if at all, is some of the comments by some trying to derail this, trying to scare people i saying there is going to be huge medicare cuts and that type of thing. medicare is not included in this bill. bill.are not cuts in this we have had town meetings and discussions back at home, for folks there is a genuine fear that in fact this build is something that in fact it does not. we provide this protection's that we want -- and those protections that we want. i would've thought we have -- we would have gone much farther after 11 hours and having one amendment that has yet to be disposed of and that only impacts the title but we are prepared to stay long and at the end of the process, i hope it can be a productive one that

reaches the house >> the chair recognizes the gentlelady for five minutes. >> we do believe this bill is a pay more for less scheme. i would like to support this in honor of my constituent mary sutherland. i am speaking on behalf of the people of the ninth congressional district who in solidarity with the women, men and children who will be impacted by this misguided piece of legislation. mending our health-care system is the most important issue facing the american people. they deserve to know what is in the bill.

i have received hundreds of calls from people in my district. real people, whose lies has been saved -- lives have been saved thanks to the affordable care act. the aca has immeasurably family's health, financial security and peace of mind. her husband was diagnosed with cancer of the salivary gland around the time of their daughter's first birthday. they were devastated. the thought of their daughters losing her dad and being a young widow was terrifying. at the same time, her husband learned that due to a merger, he would likely be laid off on the job where he had worked for the past decade. it was a terrifying time for the family. they found some comfort in the fact that thanks to the aca

out-of-pocket expenses and provisions about pre-existing conditions, they could rest easy knowing their family would not medical bills,y and that insurance companies would not be able to deny them the coverage that he was due due to his health history. in the end, the sutherland's underwent successful surgery to remove his tumor, and he was able to find another job. my constituent and in conversation by saying our family has been slowly recovering the hope and optimism that we felt before his cancer diagnosis. his cancer could return at any time. even if it doesn't, if the aca , he could be denied coverage as a cancer survivor. removing the aca would make it more likely that she would grow

up without a father. they are terrified at the prospect of losing the protection that the aca has provided to their families. these are real statements from real people. real people who are frightened to lose their health insurance. losing their health insurance means loss of access to medication and lifesaving cures. three point 4 million new yorkers will lose their coverage if the aca is repealed and if this replacement is put in place. country more around the will lose their care altogether. at this time, i would like to yield the balance of my time to the gentlelady from florida. >> i think miss clark for yielding the time. they appeared to elicit the fact that the majority may have some

documents related to the scoring. i would like to ask counsel if you have all talked with cbo over the past couple weeks on this version of this bill? >> there have been ongoing discussions with the budget office. >> were any of those done in writing? >> the communication takes place verbally and in person meetings, generally. no emails that were exchanged with congressional budget office over how you scored the bill? typically it takes place because of technicalities. >> typically -- >> if i have received email, it is generally requesting time to speak and time to meet. >> could you provide those

documents so that we can have a better idea? >> will the gentlelady yield? i don't think that is an appropriate request to provide. >> we are being asked to vote a bill that affects everyone across the country without having any information. general time has expired. we are not conducting an investigation at this time. expired.me has the gentleman from virginia, for five minutes. >> i find it interesting that we are currently debating the title to the bill. it is an interesting principle of parliamentary procedure that one should not be amending a bill unless the amendment were to be adopted, they plan to vote for the bill. thatsence, based upon principle, the democrats are

telling us that if we merely change the title, they would be able to get the bill. time,it has changed over they used to appoint committees, they did not have standing committees. jefferson lies out in his parliamentary procedure that it is to be a part of the committee, but none who speak directly against the body of the bill should be a part of the committee dealing with amendments to the bill. you don't amend the bill unless if your amendment is adopted you are willing to vote for it. he goes on to say that for he that will totally destroy will not amend it. he that would totally destroy will not amend it. referencing the bill -- the child is not to be put to a nurse that cares not for it.

i would submit that it appears the title is more important than the substance to my friends on the other side of the aisle. i would hope that was not the case, but it does seem we have spent hours and hours worrying asut the title of this bill opposed to getting down to the policy. i have also heard comments made that the other side has been willing to work with us. my experience was early on and continued until november was that every time we would raise some issue related to the affordable care act, we were met weh derision and talks that were crazy or just did not want to go forward with this great plan they had. tonight we hear they recognize there are many problems and they would love to work with us, but that is not what i heard before. i hear about documents and trying to get documents, our committee is still trying to get documents which we were told we

weren't going to get from the obama administration, trying to aboutine how they came the cost-sharing subsidies without authority to spend that money. it is in the bill, but the money is not in the bill. the democrat senate removed the cost-sharing subsidy portions of the port that paid for that -- the part that paid for that. the obamanued in administration to spend that money without authority from congress. gotten those documents. before we worry about what documents may have been floating cbond out there about a score, perhaps we can get some real information on the affordable care act it self and how they have been operating it without local authority. i have stories from back home, as we were all out over the last year. we have heard many stories. i appreciate that. when a lady tells me she is worried that it is killing her family financially, their deductibles are too high.

she says her husband's sake and as a result of that they are selling assets. deductibles are so high they cannot afford these so-called affordable care act and asked me to get rid of it. i get letters on a regular basis from constituents who tell me that they cannot afford the affordable care act, they don't understand why this system is so poor. people tell me it is hurting everything that they are doing. conversations that just come up where parents are trying to decide whether or not they buy the medication for their children. whether or not they should buy the medication for their children because it is not a life-threatening illness and it might make them feel a little better, but their co-pay is so high and their deductible is so high that they are not sure if it is worth spending the money.

they are having that debate in their households. that anybodyou that thinks that the affordable care act is in fact working is mistaken. we need to be coming up with a new plan. i think this proposal before us .onight is a good plan it is far better than what is currently on the table. i hope we will get onto passing it. if there are some constructive amendments, i would like to see them. debating about the cute title to poke fun at republicans is not really wanting to work with us, it is just playing more game. >> who seeks time on the minority side? seeing none. oh, the gentlelady from michigan. five minutes. >> thank you mr. chairman. palomae to support the

-- pallone amendment. studentseting with whose lives have been significantly impacted by the affordable care act. the aca was impacted, the uninsured rate has fallen. i go, people come up to be scared to death and ask what is going to happen to their health care. i walked into starbucks a month ago and a woman just broke into tears. there was a topic of a roundtable discussion i helped with health care providers, labor leaders and working emily used to talk about what the aca means to them. the story that struck me the most was from a local clergymen. he gained coverage for the first time through the medicaid expansion. he tells me quote -- the impact on black men with increased

access to insurance coverage is the. we did not take care of ourselves until it was too late, then we had to go to the er. sometimes, some of us died. now we can go get checked out early. uaw workerm a local who told me he came from a family remember of its families -- many of its members got cancer. they were not able to get health care coverage after they left their job or would have gone bankrupt without the aca. a couple weeks ago, i met with whoors, nurses and patients told me that 60,000 beaumont patients were covered through medicaid expansion. i heard the story of a 56-year-old mother of two who works at a small business with only three employees, where no health care coverage was offered, and where she makes marginal income at best. she did not have insurance prior to the aca.

with the marketplace first opened, she was so relieved. she has suffered a heart attack and a broken shoulder. the emergencies were one thing. the woman had not seen a doctor for preventative care in years. her sister wrote and wondered if maybe a heart attack could have been avoided. on heart medication covered by insurance and getting healthier every day. she would routinely go for all of her preventative screenings and is more vigilant about her health. can you imagine what her bills would have been without the aca? life would not have been the same for her or her children. ins is about real people their lives and making health care accessible and at fort will cost. -- at affordable cost. these will be the people who pay the price if the aca is repealed

and medicaid expansion is thrown out. we keep talking in stories. there are stories from both sides. weforget about the people were watching before the affordable care act past that were cutting their pills in half. they could not afford to eat or were making decisions. areave to make sure that we not going to penalize people who suddenly have hope and take that hope away from them again. the aca may not be perfect, but it is significantly benefit late -- benefiting families in my district and across the country. we cannot take that away. >> thank you. i have been, since sharing some of these quotes, i thought it might continue.

i think i ended with the natural review. all in all, this bill is a disappointment and is not too late to get a second opinion. we heard from a conservative commentator. the house gop's obamacare replacement will make insurance unaffordable for millions. a kind of -- the critical mistake of the eight h ca is the insistence on -- the ahca is the insistence on credits. it will force poor and vulnerable people out of the insurance market. on the house gop plan, it won't work. worse than obamacare itself. chairman, i just certainly hope we take time to read some of these articles and understand what others out there, especially for my friends on the other side of the aisle, people

that generally agree with your approach is to legislation. i will close with this. jennifer rubin -- >> time is now expired. >> arguably the most irresponsible display of governments in my lifetime. >> any other members seeking recognition? of course there are. mr. tomko, we are delighted to welcome you to this party. earlier, it is stated that this bill does nothing to eliminate the essential health benefits in the marketplace. there seems to be some disagreement amongst republican colleagues as to that thinking and also seems to go against the aboutic of republicans government mandated benefits. my question for you is will you pledge to the american people that your party will not eliminate or reduce the

essential health benefits portion as it relates to the marketplace as a move forward on negotiations? >> i'm sorry, was that a question to me? >> would you pledge to continue -- you stated there is nothing about eliminating the essential health benefits in the marketplace with this bill. i said there seems to be some disagreement amongst your colleagues about that thinking. it seems to go against the rhetoric of republicans that government mandated benefits should not be imposed on people. my question is will you pledge to the american people to not eliminate or reduce via your party any of the essential health benefits in the marketplace? --here's what i will pledge we will save the individual marketplace from total and utter collapse, which is what it is on now on the individual

marketplace. every three counties, you only have one choice and it is getting skinnier than that of the word. we want to make sure people have access to affordable health insurance. i think the councils have addressed what this legislation does at its present time on it essential benefits. thepecifically about essential health benefits package that you say is not eliminated in this bill. will you pledge that you and your party will keep those in place as we go forward? >> i think we have had our discussion about the essential benefits today. there are questions raised about them. i feel like we have addressed the questions. >> do you pledge to keep them in the bill? in an open legislative process as we speak. i'm going to do the will of the -- that is not quite what i said. >> not yes. >> is your time.

>> i will ask again. will you pledge to keep them in the package? >> this is your time to debate the bill. you are welcome to do that. >> i guess i didn't get affirmative answers to that. i write in support of the paloma amendment in behalf of all the constituents who have renovated from the affordable care act. one constituent shared her story with me. andstates i am 58 years old am an ovarian cancer survivor. i was diagnosed with late stage cancer in 2009. at that time i was covered through my government job with a $4000 annual deductible. i get excellent insurance, but my treatment to 18 months. costround of chemotherapy $5,000. i stopped adding the bills up at

500,000 dollars. i came close to my lifetime cap. dustmy treatment was con done, it cost millions of dollars. i wouldn't bankrupt without the aca laws. beeny likely would have cap's in my lifetime limit. she goes on to state to move closer to her daughter and shifting work environments. i never got my stamina back and had a demanding job that required a lot of travel. i was too fatigued to keep up so i retired early. i have since returned to the workforce. forgoes on to make mention all this great activity that was covered by the affordable care act. when i asked her if there was anything she could tell the people who wanted to repeal aca, she told me it was a life and death matter. if you do not give people

health, they will not give efforts back to the community. when you are struggling to make ends meet and don't have health care, you will not donates to the community you call home. on and says while it may not be perfect, but dang it was a good start. i agree with my constituent. it was a dang good start and we can't go backwards. >> time has expired. are there other members seeking recognition? gentleman from massachusetts, mr. kennedy. >> two points i would like to make. one is a couple letters for my constituents. we have heard voices on both sides of the aisle, which i appreciate. iwant to make sure just as hear your stories, you also hear ours. benefitedpeople that

and continued to benefit for this bill. one writes that this is just what was done before the aca. and why 12, there was a fire in our building and a bedroom full of smoke. insurance company proceeded to lie to us and the hospital for months. claiming they were still processing. in the end, my husband had to pay thousands of dollars out of his own paul -- own pocket. it is necessary for there to be options for individual plans. we felt so blessed to be able to continue our work without the insurance companies defrauding it. another woman writes that a very dear family member of mine has polycystic kidney disease, a chronic pre-existing condition.

finde we were not able to coverage for them because of their ppb -- pkd. fromer letter coming in pamela from west new rights that she struggled with mental illness. they rely on day treatment centers to stay out of the hospital. that is help the medicaid plan in massachusetts. before going to day treatment , after being admitted to a local community center, i was able to make strides toward stability. these stories are very real. these benefits are very real. hear those voices and those stories as you go through these reform efforts. the second point i want to make because it has been said over and over again that the aca is a job killer.

i represent a state with a 2.8% unemployment rate. the fact this is a job killer is just false. you would see when they come together to make this bill work? come to massachusetts. of you who wonder if it is repealed, there is some data out there about the job loss and several results from the aca repeal. california, 330,600 jobs lost. florida, 181,000 jobs lost. illinois, 114,300 jobs lost. lost.a, 55,000 400 jobs kentucky, 44,500 jobs lost. louisiana, 36,800 jobs lost. michigan, 101,500 jobs lost. mississippi, 16,400 jobs lost.

missouri, 46,100 jobs lost. new jersey, 86,400 jobs lost. near, 137,000 jobs lost. dakota, 8200. >> will determine yield? >> not yet, we are getting there. pennsylvania, 137,200. tennessee -- texas 174,000. >> will the gentleman yield? >> i am telling you we are almost there. west virginia, 16,500 jobs. ok? now i am done. >> i was just wanted to see if i was as good a friend to you as you were to me. i yielded to you pretty quick. what source are you using for that? .> the commonwealth fund

i can give you the website if you would like. >> who are they funded by? >> i don't know that. i am guessing it is not going to be the republican national committee with those figures. i amjust say that, because all about statistics. i love numbers. i want to make sure we're using right numbers. governor, andyour what he says is under mass care, you have 97% under romney care. when the aca took effect, 7 million people went off private insurance. their bill in your state was another $1.3 billion addition on medicaid, which meant as a 50-50 state, billions were taxpayer support as well.

the same number, but what aca has done in massachusetts is move people off private insurance onto medicaid, which costs the state $1.3 billion and federal taxpayers $1.3 billion. >> likely we have a republican governor who is trying to get a business feed to make sure we maintain high-quality coverage. our governor has been one of the leading voices about the importance of medicaid expansion. -- and he is as republican -- other members seeking recognition? mr. peters. mr. kennedy's numbers , but i'm not sure about the water being warm in massachusetts. i want to introduce you to my friend charlie mann. charlie is a young lady that i met. i'm going to read a letter from her mother.

ladies and gentlemen, i am writing today to ensure my three-year-old daughter charlie has access to the medical care she needs as a child fighting cancer. average american middle class family. we have two daughters ages seven and three. my husband and i both have good jobs and own our home in san diego. in june 2016, we heard those words no parent is prepared to hear -- your child has cancer. our healthy three-year-old had been diagnosed with leukemia. very next concern was i hope our insurance covers this. medical bills over a six-month period have reached a quarter million dollars excluding prescriptions. that is the equivalent to 3000 tickets to disneyland, 230 three plane tickets to visit her family and ireland.

they both work for businesses that are not required to have insurance. they are currently enrolled in a hmo program. they are limited to which insurance program they can purchase and it can only be provided by specialist at a children's hospital. with our current plan we have spent $6,500 in addition to the 400 -- $4700 we will spend all she undergoes treatment. completing her current 2.5 years of chemo treatment, she is at risk for numerous future complications. she is also at high risk of developing secondary cancers. i am not asking for a handout. . work hard i think the misconception is that the informal health care act only benefits people who are needy, poor, or not working, which is untrue. to guarantee people like my daughter has access to affordable health care who otherwise would he denied based on pre-existing health conditions.

the affordable care act is revoked, my daughter will lose health care. she will also be discriminated against in the future when applying for future health insurance by being denied or charged more. as a mother, my focus needs to be on charlie and my family and not construct -- distracted over concerns of losing health care coverage or how we will afford it. my daughter needs access to health insurance to have a long life. today tocharlie's mom make sure she was doing ok. she was eager to have her story told. problem il you, the have with this whole process is i know folks on the other side will say don't worry, you will be covered. i have heard, again, since the draft of this law was released or declassified, that hospitals, doctors and the aarp and